The aim of this study was to evaluate the outcomes of Cool and Clean, Switzerland’s largest substance use prevention programme, targeted specifically at 10- to 20-year-olds who belong to a sports club and train as part of a team.
Method:
Based on a representative sample of young people who belong to a sports club and train as part of a team (both participants and non-participants in ‘cool and clean’), a post-test–only static group comparison was used to analyse data on 1,887 individuals from 179 teams (mean age: 13.8; 33.5% girls). Outcome variables included sports-related aspects (achievement motivation, fair play); attitudes towards tobacco, cannabis and alcohol use, and doping; and substance use (tobacco, cannabis and alcohol use).
Results:
Cool and Clean participants self-reported beneficial effects of the programme in all outcome areas. They also had a more critical attitude towards doping and substance use in general and had a lower reported frequency of cannabis use than non-participants. We found no significant group differences in terms of sports-related variables, tobacco and alcohol use. However, in each of these areas, better outcomes were found among Cool and Clean participants who trained with teams that implemented the programme more comprehensively.
Conclusions:
There is cross-sectional evidence for the effectiveness of the Cool and Clean programme. Moreover, the level of impact of the programme depends not only on participation per se but also, and more decisively, on how comprehensively the programme is implemented.
AnnaheimBWickiMSchmidHet al. (2007) Evaluation Des Präventionsprogramms ‘Cool and Clean’ Bei Jugendlichen - Breitensport Und Talents [Evaluation of the «Cool and Clean» Prevention Programme Among Young People in Sports-for-all and Swiss Talents] (Forschungsbericht Nr. 43). Lausanne: Schweizerische Fachstelle für Alkohol- und andere Drogenprobleme (SFA).
2.
BodenJMFergussonDM (2011) The short and long term consequences of adolescent alcohol use. In: SaundersJBReyJM (eds), Young People and Alcohol: Impact, Policy, Prevention and Treatment. Chester: Wiley-Blackwell, pp. 32–46.
3.
ChassinLForaDBKingKM (2004) Trajectories of alcohol and drug use and dependence from adolescence to adulthood: The effects of familial alcoholism and personality. Journal of Abnormal Psychology113: 483–498.
4.
ChenPJacobsonKC (2012) Developmental trajectories of substance use from early adolescence to young adulthood: Gender and racial/ethnic differences. Journal of Adolescent Health50: 154–163.
5.
CrispBRSwerissenH (2003) Critical processes for creating health-promoting sporting environments in Australia. Health Promotion International18: 145–152.
DasJKSalamRAArshadAet al. (2016) Interventions for adolescent substance abuse: An overview of systematic reviews. Journal of Adolescent Health59: S61–S75.
8.
DobbinsonSJHaymanJALivingstonPM (2006) Prevalence of health promotion policies in sports clubs in Victoria, Australia. Health Promotion International21: 121–129.
9.
DurlakJADuPreEP (2008) Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation. American Journal of Community Psychology41: 327–350.
10.
EwingSWSakhardandeABlakemoreSJ (2014) The effect of alcohol consumption on the adolescent brain: A systematic review of MRI and fMRI studies of alcohol-using youth. NeuroImage: Clinical5: 420–437.
11.
FaggianoFMinozziSVersinoEet al. (2014) Universal school-based prevention for illicit drug use. Cochrane Database of Systematic Reviews12: CD003020.
12.
Ferrer-WrederLCadelyHSDomitrovichCEet al. (2010) Is more better? Outcome and dose of a universal drug prevention effectiveness trial. The Journal of Primary Prevention31: 349–363.
13.
FlatzAPfeiferNRadtkeTet al. (2016) Interventions implemented through sporting organisations for promoting healthy behaviour or improving health outcomes. Cochrane Database of Systematic Reviews5: CD012170.
14.
GeidneSQuennerstedtMErikssonC (2013) The youth sports club as a health-promoting setting: An integrative review of research. Scandinavian Journal of Public Health41: 269–283.
15.
Giles-CortiBClarksonJPDonovanRJet al. (2001) Creating smoke-free environments in recreational settings. Health Education & Behavior28: 341–351.
16.
GordonR (1983) An operational classification of disease prevention. Public Health Reports98: 107–109.
17.
GriffinKWBotvinGJ (2010) Evidence-based interventions for preventing substance use disorders in adolescents. Child and Adolescent Psychiatric Clinics of North America19: 505–526.
18.
HemphillSAHeerdeJAHerrenkohlTIet al. (2011) Risk and protective factors for adolescent substance use in washington state, the United States and Victoria, Australia: A longitudinal study. Journal of Adolescent Health49: 312–320.
19.
HigginsJPThompsonSGDeeksJJet al. (2003) Measuring inconsistency in meta-analyses. BMJ327: 557–560.
20.
InchleyJCurrieDYoungTet al. (2016) Growing up unequal: Gender and socioeconomic differences in young people’s health and well-being. Health Behaviour in School-aged Children (HBSC) study: International report from the 2013/2014 survey. Health Policy for Children and Adolescents. Copenhagen: WHO Regional Office for Europe.
21.
KingslandMWiggersJHVashumKPet al. (2016) Interventions in sports settings to reduce risky alcohol consumption and alcohol-related harm: A systematic review. Systematic Reviews5: 12.
22.
KokkoS (2014) Sports clubs as settings for health promotion: Fundamentals and an overview to research. Scandinavian Journal of Public Health42: 60–65.
23.
KokkoSGreenLWKannasL (2014) A review of settings-based health promotion with applications to sports clubs. Health Promotion International29: 494–509.
24.
LamprechtMFischerAStammHP (2011) Sportvereine in Der Schweiz [Sports Clubs in Switzerland]. Magglingen: Bundesamt für Sport BASPO.
25.
LimSSVosTFlaxmanADet al. (2012) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. The Lancet380: 2224–2260.
26.
PayneWReynoldsMBrownSet al. (2002) Sports Role Models and Their Impact on Participation in Physical Activity: A Literature Review. Victoria, Australia: University of Ballarat.
27.
PinquartMSilbereisenRK (2004) Prävention und Gesundheitsförderung im Jugendalter [Prevention and health promotion during adolescence]. In: HurrelmannKKotzTHaischJ (eds), Lehrbuch Prävention Und Gesundheitsförderung [Textbook for Prevention and Health Promotion] (pp. 63–71). Bern: Verlag Hans Huber.
28.
PriestNArmstrongRDoyleJet al. (2008) Policy interventions implemented through sporting organisations for promoting healthy behaviour change. Cochrane Database of Systematic Reviews3: CD004809.
29.
RehmJTaylorBRoereckeMet al. (2007) Alcohol consumption and alcohol-attributable burden of disease in Switzerland, 2002. International Journal of Public Health52: 383–392.
30.
RiggsNRChouCPLiCet al. (2007) Adolescent to emerging adulthood smoking trajectories: When do smoking trajectories diverge, and do they predict early adulthood nicotine dependence?Nicotine & Tobacco Research9: 1147–1154.
31.
SolèrMZumbrunnASchmidH (2015) Theoriegestützte Weiterentwicklung Des Präventionskonzepts Von «Cool and Clean» [Theory-based Advancement of the Preventive Strategy of «Cool and Clean»]. Olten: Fachhochschule Nordwestschweiz, Hochschule für Soziale Arbeit.
32.
SpectorPE (1981) Research Designs. Thousand Oaks, CA: SAGE.
33.
StataCorpLP (2013) Stata Statistical Software: Release 13. College Station, TX: StataCorp.
34.
StuckiSKuntscheEArchimiAet al. (2014) Does smoking within an individual’s peer group affect intervention effectiveness? An evaluation of the Smoke-Free Class Competition among Swiss adolescents. Preventive Medicine65: 52–57.
35.
StuckiSWickiM (2015) Evaluation Des Präventionsprogramms «Cool and Clean» Teilstudie 1B - Umsetzung Von «cool and clean» Bei Sportlich Aktiven Jugendlichen Im Breitensport [Evaluation of the «Cool and Clean» Prevention Program - Implementation of «Cool and Clean» among Young People in Sports-for-all]. Lausanne: Sucht Schweiz.
36.
StuckiSWickiM (2016) Evaluation der Umsetzung von «cool and clean» im Breitensport [Evaluation of the implementation of «cool and clean» in sports-for-all]. Suchtmagazin42: 17–20.
37.
The ESPAD Group (2016) ESPAD Report 2015: Results from the European School Survey Project on Alcohol and Other Drugs. Lisbon: European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)
.
38.
WarrenCWJonesNREriksenMPet al. (2006) Patterns of global tobacco use in young people and implications for future chronic disease burden in adults. The Lancet367: 749–753.
39.
WickiMRohrbachWStuckiSet al. (2011) Evaluation Des Präventionsprogramms «Cool and Clean» Bei Jugendlichen – Breitensport Und Talents [Evaluation of the «Cool and Clean» Prevention Program among Young People - Sports-for-all and Talents]. Lausanne: Sucht Info Schweiz.
40.
WickiMStuckiSMarmetS (2015) Evaluation Des Präventionsprogramms «Cool and Clean» Teilstudie 1A - Wirkung Von «Cool and Clean» Bei Sportlich Aktiven Jugendlichen Im Breitensport - [Evaluation of the «Cool and Clean» Prevention Program - Effects of «Cool and Clean» among Young People in Sports-for-all]. Lausanne: Sucht Schweiz.
41.
WickiMStuckiSRohrbachWet al. (2012) Evaluation des Präventionsprogramms «cool and clean» bei Jugendlichen im Breitensport [Evaluation of the «cool and clean» prevention programme among young people in sports-for-all]. Abhängigkeiten18: 46–65.
42.
World Health Organization (WHO) (1997) Life Skills Education in Schools. Geneva: Author.
43.
World Medical Association (2013) World medical association declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA310: 2191–2194.
